Sepsis-associated electroencephalographic changes in extremely low gestational age neonates.

Area of Science:

• Neonatal neurology
• Pediatric critical care
• Neurophysiology

Background:

• Sepsis in premature infants is a known risk factor for poor neurodevelopmental outcomes.
• Previous research has not investigated acute alterations in brain function during sepsis in this vulnerable population.
• Understanding these acute changes may help predict long-term neurodevelopmental trajectories.

Purpose of the Study:

• To investigate acute changes in brain function in premature infants experiencing sepsis.
• To determine if sepsis is associated with specific electroencephalographic patterns, such as burst suppression.
• To assess the impact of sepsis on the rate of brain wave maturation.

Main Methods:

• Amplitude-integrated electroencephalography (aEEG) was used to monitor brain activity in 108 premature infants (born <28 weeks gestation) from 28 to 36 weeks postmenstrual age.
• aEEG recordings were also obtained during the infants' first sepsis episode.
• Two blinded readers evaluated aEEG for burst suppression and assigned a maturation score, independent of clinical data.

Main Results:

• Burst suppression was significantly more common in infants with sepsis (57%) compared to those without (22%) (OR=4.2, P<0.001).
• This association remained significant after adjusting for postmenstrual age (OR=2.4, P=0.01).
• No significant difference in the rate of aEEG maturation score increase was observed between infants with and without sepsis.

Conclusions:

• Sepsis is associated with acute electroencephalographic changes, characterized by increased burst suppression.
• The rate of brain wave maturation does not appear to be significantly affected by sepsis in the acute phase.
• These findings highlight specific neurophysiological alterations during sepsis in premature infants.